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Xu L, Wu S. New diagnostic strategy for multiple myeloma: A review. Medicine (Baltimore) 2023; 102:e36660. [PMID: 38206744 PMCID: PMC10754592 DOI: 10.1097/md.0000000000036660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 11/22/2023] [Indexed: 01/13/2024] Open
Abstract
Multiple myeloma (MM) is the second most prevalent hematological malignancy and is distinguished by the aberrant proliferation of monoclonal plasma cells inside the bone marrow and production of M-protein. This condition frequently results in bone deterioration, acute kidney damage, anemia, and hypercalcemia. However, the clinical manifestations and accompanying symptoms of MM vary and may change as the condition evolves. Therefore, diagnosis of MM is difficult. At present, the confirmation of MM diagnosis necessitates the use of bone marrow biopsy, a procedure that is both invasive and challenging for assessing dynamic alterations in the disease. The integration of laboratory testing technologies with imaging technology has the potential to enhance the diagnostic effectiveness and provide a thorough evaluation of disease progression and prognosis in patients with MM. All the examination methods have advantages and disadvantages. Therefore, diagnosis is determined by the application of clinical characteristics, serological tests, and imaging investigations.
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Affiliation(s)
- Ligong Xu
- Department of Radiology, The First Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Shuang Wu
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
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Zhang Y, Jiang X, Ye W, Sun J. Clinical features and outcome of eight patients with Chlamydia psittaci pneumonia diagnosed by targeted next generation sequencing. Clin Respir J 2023; 17:915-930. [PMID: 37552996 PMCID: PMC10500319 DOI: 10.1111/crj.13681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/29/2023] [Accepted: 07/23/2023] [Indexed: 08/10/2023]
Abstract
INTRODUCTION The clinical symptoms of Chlamydia psittaci pneumonia are still poorly understood. This study was designed to summarize the clinical features and outcome of eight C. psittaci pneumonia patients diagnosed by targeted next generation sequencing (tNGS). METHODS We included eight C. psittaci pneumonia patients admitted to our hospital from January 2021 to July 2022. The tNGS was performed to the samples collected from bronchoalveolar lavage fluid of each patient. Their clinical data were analysed, including baseline features, clinical symptoms, chest radiographic findings and laboratory examinations. RESULTS The tNGS sequence number for C. psittaci was in a range of 10 to 1722. The radiographic characteristics were mainly featured by patchy consolidation shadows, ground-glass density shadows, air bronchogram and slight pleural effusion. Within 1-3 days after hospitalization, most patients showed increased neutrophil ratio, C-reactive protein and erythrocyte sedimentation rate, and decreased lymphocyte count, total protein, albumin and prealbumin. Some patients showed increased glutamic-pyruvic transaminase, glutamic-oxaloacetic transaminase and lactate dehydrogenase levels. Three critically ill patients showed increased creatine kinase, creatine kinase isoenzyme and high-sensitivity troponin T (hs-TnT) levels. CONCLUSIONS A poultry or bird contact history, typical flu-like symptoms, patchy consolidation, ground-glass density shadow and air bronchogram may contribute to the diagnosis and treatment of C. psittaci pneumonia. Increase in creatine kinase, creatine kinase isoenzyme and hs-TnT may indicate a severe condition. Moxifloxacin and minocycline were effective in the management of C. psittaci pneumonia.
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Affiliation(s)
- Yanping Zhang
- Department of Respiratory MedicineShandong Provincial Third HospitalJinanP.R. China
| | - Xiangsen Jiang
- Imaging CenterShandong Provincial Third HospitalJinanP.R. China
| | - Wei Ye
- Department of Respiratory MedicineShandong Provincial Third HospitalJinanP.R. China
| | - Jinlin Sun
- Department of Respiratory MedicineShandong Provincial Third HospitalJinanP.R. China
- Department of Respiratory MedicineHui Ya Hospital of The First Affiliated Hospital, Sun Yat‐Sen UniversityHuizhouP.R. China
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Yang JL, Qiu YL, Wang WL, Zhu Y, Cai XY, Liu JF, Zhang HT, Chen YF. [Clinicopathological Characteristics of Lymphadenitis Caused by Talaromyces marneffei Diagnosed by Core Needle Biopsy]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2022; 44:440-445. [PMID: 35791942 DOI: 10.3881/j.issn.1000-503x.14639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective To analyze the clinicopathological characteristics of lymphadenitis caused by Talaromyces marneffei (TM).Method s The clinical data,pathological features,pathogen examination,and treatment of 15 cases of TM-caused lymphadenitis were analyzed retrospectively.Results The 15 cases included 14 males and 1 females,who were aged 26-67 years,with an average age of (49.1±11.87) years.The 15 cases,including 13 cases of acquired immunodeficiency syndrome and 2 cases of diabetes mellitus,were accompanied by superficial lymph node enlargement in the neck and supraclavicular,axillary,and inguinal regions.The structure of cord-like lymph node tissue punctured by thick needle was completely or partially replaced by inflammatory lesions. Under microscope,8 cases showed mainly diffuse infiltration of phagocytes with pathogens;5 cases presented mainly extensive coagulation necrosis with a small amount of pathogens and nuclear debris;2 cases were characterized by small nodular hyperplasia of fibroblasts,formation of granulomatous structure,and scattered distribution of a few multinucleated giant cells.The pathogens were relatively consistent in size and shape,which were round,oval or sausage-shaped and clustered like mulberry.Diastase periodic acid-Schiff staining and hexamine silver staining highlighted the bacterial structure with transverse septum.TM growth was detected in the blood,alveolar lavage fluid,sputum or lymph node extract fungal culture of the 15 patients.Owing to the adequate antifungal treatment in time,these 15 patients were discharged after their conditions were improved.Conclusion Lymphadenitis is one of the major manifestations of the systemic invasion of TM at the late stage,which is tended to be misdiagnosed.Through core needle biopsy of lymph node,it can be diagnosed as soon as possible to avoid delayed treatment and improve the cure rate.
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Affiliation(s)
- Jin-Ling Yang
- Department of Pathology,,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou,Fujian 362000,China
| | - Yi-Li Qiu
- Department of Pathology,,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou,Fujian 362000,China
| | - Wan-Ling Wang
- Department of Pathology,,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou,Fujian 362000,China
| | - Yan Zhu
- Department of Laboratory,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou,Fujian 362000,China
| | - Xue-Yu Cai
- Medical Record Department,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou,Fujian 362000,China
| | - Jiang-Fu Liu
- Department of Infectious Diseases,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou,Fujian 362000,China
| | - Hong-Tu Zhang
- Department of Pathology,National Cancer Center,National Clinical Research Center for Cancer,Cancer Hospital,CAMS and PUMC,Beijing 100021,China
| | - Yi-Feng Chen
- Department of Pathology,,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou,Fujian 362000,China
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Liu C, Jin Y, Huang H, Ding F, Xu X, Bao S, Yang Z, Jin Y. Clinical and laboratory features of childhood-onset primary Sjögren's syndrome: A retrospective study from China. Front Pediatr 2022; 10:1044812. [PMID: 36683822 PMCID: PMC9846242 DOI: 10.3389/fped.2022.1044812] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/05/2022] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION The initial presentations of childhood-onset primary Sjögren's syndrome (C-pSS) vary, making diagnosis challenging. We aimed to improve the diagnosis and evaluation of C-pSS by summarizing its clinical and laboratory features. METHODS A total of 49 patients with C-pSS between July 2015 and August 2022 in the Department of Rheumatology and Immunology of Shanghai Children's Medical Centre were enrolled in this study. Their clinical manifestations and laboratory examinations of these patients were compared based on the presence or absence of thrombocytopenia and parotitis and whether the immunological markers, including anti-nuclear antibodies (ANA), rheumatoid factor (RF), anti-Ro52/SSA antibodies (anti-SSA/Ro52), anti-Ro60/SSA antibodies (anti-SSA/Ro60), and anti-Ro/SSB antibodies (anti-SSB), were positive. RESULTS The mean age at C-pSS diagnosis was 10.34 ± 3.45 years, and the ratio of boys to girls was 1:6. In the thrombocytopenia group, parotitis (P = 0.044), organ involvement except for hematology (P = 0.002), positive anti-SSB (P = 0.004), and positive RF (P = 0.001) were less frequently observed. Complement C4 (P = 0.038) and white blood cells (P = 0.002) levels decreased and increased significantly, respectively. Anti-SSB (P = 0.010) and RF (P = 0.004) positivity were independent potential protective factors against thrombocytopenia in patients with C-pSS. In the parotitis group, higher ANA titers (P = 0.027), higher focus scores on labial gland biopsy (P = 0.024), and positive RF (P = 0.001), anti-SSA/Ro60 (P = 0.003), and anti-SSB (P = 0.001) were observed more frequently. Furthermore, positive anti-SSB (P = 0.012) and positive RF (P = 0.028) were independent risk factors for parotitis in patients with C-pSS. The hemoglobin level was significantly lower in patients with positive anti-SSA/Ro52 and positive anti-SSA/Ro60 results (P = 0.022 and P = 0.029, respectively), while immunoglobulin G level was significantly higher in patients in the same group (P = 0.048 and P = 0.007, respectively). CONCLUSIONS Positive anti-SSB and positive RF values may be independent potential protective factors of thrombocytopenia in patients with C-pSS. In contrast, positive anti-SSB and positive RF were independent risk factors of parotitis in patients with C-pSS. More studies are needed to reveal the diagnostic role and pathogenic mechanism of immunological markers in C-pSS.
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Affiliation(s)
- Chenxi Liu
- Department of Rheumatology and Immunology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingying Jin
- Department of Rheumatology and Immunology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hua Huang
- Department of Rheumatology and Immunology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fei Ding
- Department of Rheumatology and Immunology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xuemei Xu
- Department of Rheumatology and Immunology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shengfang Bao
- Department of Rheumatology and Immunology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhen Yang
- Department of Rheumatology and Immunology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanliang Jin
- Department of Rheumatology and Immunology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Abstract
OBJECTIVE This research aims to develop a laboratory model that can accurately distinguish pneumonia from nonpneumonia in patients with COVID-19 and to identify potential protective factors against lung infection. METHODS We recruited 50 patients diagnosed with COVID-19 infection with or without pneumonia. We selected candidate predictors through group comparison and punitive least absolute shrinkage and selection operator (LASSO) analysis. A stepwise logistic regression model was used to distinguish patients with and without pneumonia. Finally, we used a decision-tree method and randomly selected 50% of the patients 1000 times from the same specimen to verify the effectiveness of the model. RESULTS We found that the percentage of eosinophils, a high-fluorescence-reticulocyte ratio, and creatinine had better discriminatory power than other factors. Age and underlying diseases were not significant for discrimination. The model correctly discriminated 77.1% of patients. In the final validation step, we observed that the model had an overall predictive rate of 81.3%. CONCLUSION We developed a laboratory model for COVID-19 pneumonia in patients with mild to moderate symptoms. In the clinical setting, the model will be able to predict and differentiate pneumonia vs nonpneumonia before any lung computed tomography findings. In addition, the percentage of eosinophils, a high-fluorescence-reticulocyte ratio, and creatinine were considered protective factors against lung infection in patients without pneumonia.
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Affiliation(s)
- Jiaxia Li
- Department of Neurology, the Second People’s Hospital of Hefei, Affiliated Hefei Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Li Wan
- Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People’s Hospital, Anhui Mental Health Center, Hefei, Anhui, China
- National Clinic Research Center for Mental Disorders-Anhui Branch, Anhui,China
| | - Yuan Feng
- Department of Neurology, the Second People’s Hospital of Hefei, Affiliated Hefei Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Huilin Zuo
- Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Qian Zhao
- Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Jiecheng Ren
- Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Xiaochu Zhang
- Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Mingwu Xia
- Department of Neurology, the Second People’s Hospital of Hefei, Affiliated Hefei Hospital of Anhui Medical University, Hefei, Anhui, China
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Shen Q, Peng H. Clinical evaluation on idiopathic pulmonary fibrosis. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2021; 46:309-315. [PMID: 33927079 PMCID: PMC10929938 DOI: 10.11817/j.issn.1672-7347.2021.190402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Indexed: 11/03/2022]
Abstract
Idiopathic pulmonary fibrosis (IPF) is a chronic fatal pulmonary disease characterized by complex illness condition. There is no effective treatment at present except lung transplantation. The comprehensive evaluation is helpful for the management of patients with IPF in hierarchical stages. Therefore, it is very important to evaluate IPF by various independent factors. At present, the commonly used methods for clinical evaluation on IPF include assessment of health-related quality of life, assessment of physiological function, assessment of imaging, assessment of laboratory examination, and multi-dimensional assessment system. However, there are different advantages and disadvantages on diverse evaluation methods for the evaluation of IPF.
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Affiliation(s)
- Qinxue Shen
- Department of Respiratory and Critical Care Medicine, Second Xiangya Hospital, Central South University, Changsha 410011, China.
| | - Hong Peng
- Department of Respiratory and Critical Care Medicine, Second Xiangya Hospital, Central South University, Changsha 410011, China.
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Chen Y, Geng Y, Xu X, Chen X, Gao J, Li J, Zhang X. The features comparison between patients in the ICU and general wards and between patients with different outcomes: a 2020 COVID-19 study. Ann Palliat Med 2021; 10:672-680. [PMID: 33545796 DOI: 10.21037/apm-21-25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 01/22/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND The novel 2019 coronavirus (COVID-19) has largely abated in China; however, sporadic or imported cases are still a concern, while in other countries, the COVID-19 pandemic persists as a major health crisis. METHODS All patients enrolled in this study were diagnosed with COVID-19 from February 21, 2020 to April 14, 2020 in Wuhan. We retrospectively analyzed the patients admitted to the ICU (137 patients) and general wards (114 patients) of Wuhan Leishenshan Hospital in China. The population characteristics, symptoms, and laboratory examination results between the patients in the ICU and those in the general wards were compared. Furthermore, the differences between the deceased patients in the ICU and those discharged from the ICU were compared. RESULTS There were significant differences between the two groups in terms of symptoms, including fever, shortness of breath, no presence of complications, presence of 1 complication, and presence of 3 or more complications (P<0.05). There were also significant differences between the patients in terms of the laboratory examination results including elevated urea nitrogen, creatinine, direct bilirubin, aspartate aminotransferase, total protein, albumin, creatine kinase, lactate dehydrogenase, procalcitonin, erythrocyte sedimentation rate, white blood cells, C-reactive protein, prothrombin time, activated partial thromboplastin time, fibrinogen, D-dimer, interleukin 6, interleukin 8, interleukin 10, interleukin 2 receptor, tumor necrosis factor-α, troponin I, phosphokinase isoenzyme-MB, and B-type natriuretic peptide; and decreased platelets, lymphocyte absolute value, and eosinophil absolute value (<0.05). There were 45 patients who died in ICU and 57 improved and discharged patients. There were significant differences between the two groups in the number of patients that had 1 complication and 3 or more complications (P<0.05). There were also significant differences in the laboratory examination results between the patients including elevated urea nitrogen, total bilirubin, direct bilirubin, aspartate aminotransferase, procalcitonin, white blood cells, interleukin 8, interleukin 10, phosphokinase isoenzyme-MB, and B-type natriuretic peptide; and decreased platelets and eosinophil absolute value (P<0.05). CONCLUSIONS Our findings highlight that the identified determinants may help to improve treatment of COVID-19 patients, to predict the risk of developing severe illness and to optimizing arrangement of health resources.
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Affiliation(s)
- Yuan Chen
- Department of Geriatrics, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China
| | - Yue Geng
- Department of Geriatrics, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China
| | - Xinhui Xu
- Department of Emergency Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaohua Chen
- Department of Infectious Diseases, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jie Gao
- Department of Infection Control, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China.
| | - Jian Li
- Clinical Research Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Xuemin Zhang
- Department of Geriatrics, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China.
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An YW, Yuan B, Wang JC, Wang C, Liu TT, Song S, Liu HQ. Clinical characteristics and impacts of traditional Chinese medicine treatment on the convalescents of COVID-19. Int J Med Sci 2021; 18:646-651. [PMID: 33437199 PMCID: PMC7797555 DOI: 10.7150/ijms.52664] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/30/2020] [Indexed: 02/06/2023] Open
Abstract
Objectives: A significant proportion of discharged COVID-19 patients still have some symptoms. Traditional Chinese medicine (TCM) has played an important role in the treatment of COVID-19, but whether it is helpful for discharged patients is still unknown. The aim of this study was to retrospectively analyze the impacts of TCM treatment on the convalescents of COVID-19. Methods: A total of 372 COVID-19 convalescents from February 21 to May 3 in Shenzhen, China were retrospectively analyzed, 291 of them accepted clinically examined at least once and 191 convalescents accepted TCM. Results: After retrospective analysis of the clinical data of convalescents accepted TCM treatment or not, we found that the white blood cell count, as well as serum interleukin-6 and procalcitonin decreased in TCM group. Serum γ-glutamyl transpeptidase was significantly decreased, while prealbumin and albumin increased in TCM group. Red blood cell, hemoglobin, and platelet count increased in TCM group. The mechanisms of TCM treatment might be the overall regulations, including balanced immune response, improved hematopoiesis and coagulation systems, enhanced functions of liver and heart, increased nutrient intake and lipid metabolism. Conclusions: This study suggested that TCM treatment would be beneficial for discharged COVID-19 patients. However, long-term medical observation and further study with randomized trial should be done to confirm this result. Besides, the potential molecular mechanisms of TCM treatment should be further revealed.
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Affiliation(s)
- Ya-Wen An
- Central laboratory, Shenzhen Samii Medical Center, Shenzhen, Guangdong Province, 518118, China
| | - Bo Yuan
- Department of neurology, Shenzhen Samii Medical Center, Shenzhen, Guangdong Province, 518118, China
| | - Jian-Chun Wang
- Central laboratory, Shenzhen Samii Medical Center, Shenzhen, Guangdong Province, 518118, China
| | - Cheng Wang
- Department of neurology, Shenzhen Samii Medical Center, Shenzhen, Guangdong Province, 518118, China
| | - Ting-Ting Liu
- Department of Traditional Chinese Medicine, Shenzhen Samii Medical Center, Shenzhen, Guangdong Province, 518118, China
| | - Shuo Song
- Central laboratory, Shenzhen Samii Medical Center, Shenzhen, Guangdong Province, 518118, China
| | - Han-Qing Liu
- Central laboratory, Shenzhen Samii Medical Center, Shenzhen, Guangdong Province, 518118, China
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Chen Y, Wang Z, Xiao D, Zeng H, Ma X. Predicting the Severity of Acute Appendicitis of Young Children (<3 Years Old): Development and Assessment of a New Prediction Nomogram. Front Pediatr 2021; 9:763125. [PMID: 34869120 PMCID: PMC8637160 DOI: 10.3389/fped.2021.763125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/11/2021] [Indexed: 12/29/2022] Open
Abstract
Objective: There is a lack of assessment methods of acute appendicitis in little children. The purpose of this study was to develop and internally validate a nomogram for predicting the severity of acute appendicitis of young children (<3 years old). Methods: We develop a prediction model based on a training dataset of 121 patients (<3 years old) with acute appendicitis. Admission information was collected between January 2010 and January 2021, which contained demographic characteristic, laboratory examinations, treatment and pathology type, etc. Logistic regression analysis was used to identify independent risk factors and establish the predictive model. C-index and calibration curves were applied to evaluate the performance of the nomogram. Then corrected C-index was calculated to conduct internal verification by using the bootstrapping validation. Decision curve analysis determined clinical application of the prediction model. Results: Predictors contained in the prediction nomogram included weight for age, onset time (from developing symptoms to hospital), admission temperature, leukocyte count, neutrophil ratio, and total bilirubin. Logistic regression analysis showed that weight for age (X1) < -2.32 SD (P = 0.046), onset time (X2) > 2.5 days (P = 0.044), admission temperature (X3) > 38.5°C (P = 0.009), leukocyte count (X4) > 12.185*109/L (P = 0.045), neutrophil ratio (X5) > 68.7% (P = 0.029), and total bilirubin (X6) > 9.05 μmol/L (P = 0.035) were found to be significant for predicting the severity of appendicitis. The logistic regression equation was logit (P) = -0.149X1 + 0.51X2 + 1.734X3 + 0.238X4 + 0.061X5 + 0.098X6 - 75.229. C-index of nomogram was calculated at 0.8948 (95% Cl: 0.8332-0.9567) and it still was 0.8867 through bootstrapping validation. Decision curve analysis showed that when the threshold probability ranged from 14 to 88%, there is a net benefit of using this prediction model for severity of appendicitis in little children. Conclusion: This novel nomogram incorporating the weight for age, onset time, admission temperature, leukocyte count, neutrophil ratio, and total bilirubin could be conveniently used to estimate the severity of appendicitis of young children <3 years old) and determine appropriate treatment options in time.
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Affiliation(s)
- Yang Chen
- Shenzhen Children's Hospital, Shenzhen, China.,College of Medicine, Shantou University, Shantou, China
| | | | - Dong Xiao
- Shenzhen Children's Hospital, Shenzhen, China
| | - Hongwu Zeng
- Shenzhen Children's Hospital, Shenzhen, China
| | - Xiaopeng Ma
- Shenzhen Children's Hospital, Shenzhen, China
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Zeng Z, Ma Y, Zeng H, Huang P, Liu W, Jiang M, Xiang X, Deng D, Liao X, Chen P, Chen Y. Simple nomogram based on initial laboratory data for predicting the probability of ICU transfer of COVID-19 patients: Multicenter retrospective study. J Med Virol 2020; 93:434-440. [PMID: 32603535 PMCID: PMC7361399 DOI: 10.1002/jmv.26244] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/11/2020] [Accepted: 06/24/2020] [Indexed: 01/24/2023]
Abstract
This retrospective, multicenter study investigated the risk factors associated with intensive care unit (ICU) admission and transfer in 461 adult patients with confirmed coronavirus disease 2019 (COVID‐19) hospitalized from 22 January to 14 March 2020 in Hunan, China. Outcomes of ICU and non‐ICU patients were compared, and a simple nomogram for predicting the probability of ICU transfer after hospital admission was developed based on initial laboratory data using a Cox proportional hazards regression model. Differences in laboratory indices were observed between patients admitted to the ICU and those who were not admitted. Several independent predictors of ICU transfer in COVID‐19 patients were identified including older age (≥65 years) (hazard ratio [HR] = 4.02), hypertension (HR = 2.65), neutrophil count (HR = 1.11), procalcitonin level (HR = 3.67), prothrombin time (HR = 1.28), and D‐dimer level (HR = 1.25). The lymphocyte count and albumin level were negatively associated with mortality (HR = 0.08 and 0.86, respectively). The developed model provides a means for identifying, at hospital admission, the subset of patients with COVID‐19 who are at high risk of progression and would require transfer to the ICU within 3 and 7 days after hospitalization. This method of early patient triage allows a more effective allocation of limited medical resources. In this cohort study involved 461 patients with confirmed COVID‐19, laboratory characteristics of critically ill patients was described. Risk factors associated with ICU admission and transfer was identified by Cox proportional hazard model. We transformed the complex regression equation into a visual graph (nomogram), making the results of the prediction model more readable. These findings may help predict disease progression and rationalize medical resources. If implemented, our model will be able to activate alerts in high‐risk patients early on admission.
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Affiliation(s)
- Zihang Zeng
- Department of Pulmonary and Critical Care Medicine, Second Xiangya Hospital, Central South University, Changsha, Hunan, China.,Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, China.,Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan, China
| | - Yiming Ma
- Department of Pulmonary and Critical Care Medicine, Second Xiangya Hospital, Central South University, Changsha, Hunan, China.,Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, China.,Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan, China
| | - Huihui Zeng
- Department of Pulmonary and Critical Care Medicine, Second Xiangya Hospital, Central South University, Changsha, Hunan, China.,Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, China.,Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan, China
| | - Peng Huang
- Department of Respiratory Medicine, Zhuzhou Central Hospital, Zhuzhou, Hunan, China
| | - Wenlong Liu
- Department of Respiratory Medicine, Yueyang Second People's Hospital, Designated Hospital of Junshan District, Yueyang, Hunan, China
| | - Mingyan Jiang
- Department of Respiratory and Critical Medicine, Xiangtan Central Hospital, Xiangtan, Hunan, China
| | - Xudong Xiang
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Dingding Deng
- Department of Respiratory Medicine, First Attached Hospital of Shaoyang University, Shaoyang, Hunan, China
| | - Xin Liao
- Department of Respiratory Medicine, Affiliated Shaoyang Central Hospital of University of South China, Shaoyang, Hunan, China
| | - Ping Chen
- Department of Pulmonary and Critical Care Medicine, Second Xiangya Hospital, Central South University, Changsha, Hunan, China.,Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, China.,Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan, China
| | - Yan Chen
- Department of Pulmonary and Critical Care Medicine, Second Xiangya Hospital, Central South University, Changsha, Hunan, China.,Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, China.,Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan, China
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Chen J, Peng S, Zhang B, Liu Z, Liu L, Zhang W. An uncommon manifestation of COVID-19 pneumonia on CT scan with small cavities in the lungs: A case report. Medicine (Baltimore) 2020; 99:e21240. [PMID: 32664179 PMCID: PMC7360306 DOI: 10.1097/md.0000000000021240] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/09/2020] [Accepted: 05/27/2020] [Indexed: 12/18/2022] Open
Abstract
RATIONALE Chest computed tomography (CT) scans play a key role in diagnosing and managing of COVID-19 pneumonia. The typical manifestations of COVID-19 pneumonia on a chest CT scan are ground glass opacities, consolidation, nodules, and linear opacities. It can be accompanied by a "crazy-paving" pattern, air bronchograms, pleural hypertrophy, and pleural effusion. However, no literature has reported a case with cavities in the lungs. PATIENT CONCERNS A 34-year-old male patient complained of fever, cough, fatigue, myalgia, diarrhea, headache, and dizziness for 2 weeks. This patient is living in Xiaogan, a city around Wuhan, and he had contact with a patient with COVID-19 pneumonia from Wuhan <14 days before he had fever. DIAGNOSIS A nucleic acid test by rRT-PCR returned positive on a pharyngeal swab, confirming the diagnosis of COVID-19 pneumonia. INTERVENTIONS Isolation antiviral treatment. OUTCOMES After 19 days of isolation and antiviral treatment, his temperature returned to normal and the symptoms were relieved. The laboratory results also were returning to normal levels. The chest CT scan showed that the acute inflammation had subsided significantly. With 2 consecutive novel coronavirus nucleic acid tests had returned negative, the patient was discharged from the hospital and sent to a government designated hotel for quarantine observation. The unique chest CT manifestation in this case was the small cavities in both lungs during the absorption phase of this disease. These small cavities developed into consolidated nodules with clear edges and gradually shrank or disappeared. LESSONS Although 2 consecutive nucleic acid tests returned negative in this patient, the small cavity changes in the lungs were observed, so the patient was quarantined for 14 days. However, follow-up CT after the first 14 days' quarantine showed new small cavity changes on the lungs, a further 14 days of quarantine was recommended. Therefore, in some COVID-19 cases, even if the nucleic acid tests turns negative, the disappearance of lung lesions may take a long time. The repeated chest CT scan plays an important role in the diagnosis and evaluation of the recovery of COVID-19.
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Affiliation(s)
- Jinqing Chen
- Department of Radiology, Xiaochang First People's Hospital, 1 Station Front Road, Xiaochang, Hubei
| | - Song Peng
- Department of Radiology, Chongqing Health Center for Women and Children, 120 Longshan Road, Chongqing, China
| | - Bangjun Zhang
- Department of Radiology, Xiaochang First People's Hospital, 1 Station Front Road, Xiaochang, Hubei
| | - Zhifeng Liu
- Department of Radiology, Xiaochang First People's Hospital, 1 Station Front Road, Xiaochang, Hubei
| | - Lang Liu
- Department of Radiology, Xiaochang First People's Hospital, 1 Station Front Road, Xiaochang, Hubei
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Zolotarev PN, Cherkasov SN. [The experience of application of standard values of condition of laboratory services in the subjects of the Russian Federation]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2020; 28:114-118. [PMID: 32119220 DOI: 10.32687/0869-866x-2020-28-1-114-118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 11/28/2019] [Indexed: 11/06/2022]
Abstract
The article presents information to assess possibility of using on-line questionnaires to obtain statistic data concerning activities of laboratory services in the region. The sets of standardized statistical indicators were obtained for assessing performance of such regional services as the structure of laboratory research; comparative standardized values of availability of examinations per 1000 of population; comparative standardized values of equipment support in the regions of the Russian Federation and employment rates and staffing with medical personnel of laboratories.
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Affiliation(s)
- P N Zolotarev
- The private institution educational organization of higher education "The Medical University "Reaviz"", 443001 Samara Russia,
| | - S N Cherkasov
- N. A. Semashko National Research Institute of Public Health, 105064, Moscow, Russia
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Abstract
Coronavirus disease 2019 (COVID-19) has become a global pandemic with a high rate of transmission. Currently, there is a lack of vaccines and specific drugs for this newly-emerged virus. Timely diagnosis and treatment, as well as isolation of patients and virus carriers, contribute to the effective prevention and control of this epidemic. This review focuses on early stage COVID-19 diagnosis methods and strategies, highlighting the guiding role of laboratory indicators on treatment strategy formulation, and prognosis assessments.
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Affiliation(s)
- Xueying Wang
- Lab Medicine Center, Lab of Radiation Biology, State Key Laboratory of Trauma, Burn and Combined Injury, The Second Affiliated Hospital, Army Medical University, Chongqing 400037, China
| | - Yang Zhou
- BGI PathoGenesis Pharmaceutical Technology, BGI-Shenzhen, Shenzhen 518083, China
| | - Linlin Liu
- Lab Medicine Center, Lab of Radiation Biology, State Key Laboratory of Trauma, Burn and Combined Injury, The Second Affiliated Hospital, Army Medical University, Chongqing 400037, China
| | - Jinmin Ma
- BGI PathoGenesis Pharmaceutical Technology, BGI-Shenzhen, Shenzhen 518083, China
| | - Honglong Wu
- BGI PathoGenesis Pharmaceutical Technology, BGI-Shenzhen, Shenzhen 518083, China
- BGI Wuhan Biotechnology, BGI-Shenzhen, Wuhan 430074, China
| | - Lijian Zhao
- BGI PathoGenesis Pharmaceutical Technology, BGI-Shenzhen, Shenzhen 518083, China
| | - Weijun Chen
- BGI PathoGenesis Pharmaceutical Technology, BGI-Shenzhen, Shenzhen 518083, China
| | - Shengwen Calvin Li
- CHOC Children’s Hospital Research Institute, University of California, Irvine, 1201 West La Veta Ave, Orange, CA 92868, USA
| | - Qian Ran
- Lab Medicine Center, Lab of Radiation Biology, State Key Laboratory of Trauma, Burn and Combined Injury, The Second Affiliated Hospital, Army Medical University, Chongqing 400037, China
| | - Zhongjun Li
- Lab Medicine Center, Lab of Radiation Biology, State Key Laboratory of Trauma, Burn and Combined Injury, The Second Affiliated Hospital, Army Medical University, Chongqing 400037, China
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Deng S, Qiu K, Liu H, Wu X, Lei Q, Lu W. Clinical Characteristics and Short-Term Prognosis of Autoimmune Encephalitis: A Single-Center Cohort Study in Changsha, China. Front Neurol 2019; 10:539. [PMID: 31178819 PMCID: PMC6543891 DOI: 10.3389/fneur.2019.00539] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 05/07/2019] [Indexed: 12/22/2022] Open
Abstract
Background and Purpose: The incidence and prevalence of autoimmune encephalitis is gradually increasing. This retrospective observational study primarily aimed to analyze the clinical characteristics of autoimmune encephalitis patients in the Second Xiangya Hospital and report patient prognoses after immunotherapy. Methods: The clinical data of 86 patients who were diagnosed with autoimmune encephalitis from October 2014 to September 2018 were collected, and their corresponding clinical characteristics, laboratory examination, treatment, and outcome data analyzed. Results: In our study, 72 patients (83.7%) were positive for anti-NMDAR (N-methyl-D-aspartate receptor) antibody; 5 patients (6%) for anti-GABABR (γ-aminobutyric acid receptor-A); 4 patients (4.7%) for anti-LGI1 (leucine-rich, glioma inactivated 1); 3 patients (3.5%) for anti-Caspr2 (contactin-associated protein-like 2) (1 patient was positive for both anti-LGI1 and anti-Caspr2 antibodies); and 3 patients (3.5%) for onconeural antibodies. Among the 86 patients diagnosed as having autoimmune encephalitis, 50% showed acute disease onset (≤2 weeks). The most common inducing factor was fever or cold (17/86, 19.8%). The main clinical symptoms included, among others, psychiatric disturbances (82.5%), epilepsy (60.5%), autonomic dysfunction (58.1%), sleep disorders (45.3%), consciousness disorders (45.3%), and speech disorders (46.5%). No significant correlation between ICU admission rates and CSF or serum antibody scores was observed. However, CSF antibody scores of (+ + +) and (++) were associated with longer lengths of hospitalization (p < 0.05) and a higher CSF WBC count when compared with CSF antibody scores of (+) in patients with anti-NMDAR encephalitis (p < 0.05). Additionally, there was no significant correlation between mRS score difference on admission and discharge (after immunotherapy) and age, sex, and choice of immune treatment, while immune therapy taken within 15 days from onset was more inclined to be associated with an mRS score difference ≥2 after immunotherapy in patients with anti-NMDAR encephalitis (p = 0.006). Conclusions: Autoimmune encephalitis has an acute or sub-acute onset and presents with psychotic symptoms, epilepsy, and autonomic dysfunction. The sex ratio in anti-NMDAR encephalitis was nearly balanced. Infection was a major factor inducing anti-NMDAR encephalitis, and the CSF antibody scores could be helpful in determining its prognosis since these scores showed associations with hospitalization duration and CSF WBC counts.
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Affiliation(s)
- Shuwen Deng
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Ke Qiu
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Hui Liu
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiaomei Wu
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Qiang Lei
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Wei Lu
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China
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Chen J, Wu D, Wang M, Chen E, Bai L, Liu C, Liao J, Tang H. Controlled attenuation parameter for the detection of hepatic steatosis in patients with chronic hepatitis B. Infect Dis (Lond) 2016; 48:670-5. [PMID: 27241724 DOI: 10.3109/23744235.2016.1165860] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Controlled attenuation parameter (CAP) is a non-invasive method for diagnosing liver steatosis based on vibration-controlled transient elastography. The primary objective of this study was to assess CAP performance and determine the cut-off values for the diagnosis of hepatic steatosis in patients with chronic hepatitis B (CHB) using liver biopsy as a gold standard. The second objective was to apply the cut-off values found in the first cohort to a larger cohort to compare the performance of CAP and ultrasonography. METHODS Overall, 189 patients with CHB who underwent liver biopsy and CAP detection and 1707 patients with CHB and CAP who underwent abdominal ultrasonography were prospectively enrolled. The performance of CAP for evaluating hepatic steatosis compared with liver biopsy was calculated using the area under the receiver operating characteristic curve (AUROC). RESULTS In the 189 patients who underwent liver biopsy, the cut-offs for the CAP with steatosis S ≥ 1, S ≥ 2 and S ≥ 3 were 222 dB/m, 247 dB/m and 274 dB/m, respectively, and the AUROC were 0.88 (95% confidence interval [CI] = 0.82-0.95), 0.92 (95% CI = 0.87-0.97) and 0.94 (95% CI = 0.90-0.99), respectively. After applying the cut-offs above to the 1707 patients, it was found that CAP had a good concordance with abdominal ultrasonography with steatosis grade > S2. On multivariate analysis, body mass index (p < 0.001), triglyceride level (p < 0.001) and fasting glucose level (p = 0.001) were independent risk factors of CAP. CONCLUSIONS CAP had high diagnostic performance for evaluating hepatic steatosis in patients with CHB and had a good concordance with abdominal ultrasonography.
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Affiliation(s)
- Jing Chen
- a Center of Infectious Diseases, West China Hospital, Sichuan University , Chengdu , PR China ;,b Division of Infectious Diseases, State Key Laboratory of Biotherapy , Sichuan University , Chengdu , PR China
| | - Dongbo Wu
- a Center of Infectious Diseases, West China Hospital, Sichuan University , Chengdu , PR China ;,b Division of Infectious Diseases, State Key Laboratory of Biotherapy , Sichuan University , Chengdu , PR China
| | - Menglan Wang
- a Center of Infectious Diseases, West China Hospital, Sichuan University , Chengdu , PR China ;,b Division of Infectious Diseases, State Key Laboratory of Biotherapy , Sichuan University , Chengdu , PR China
| | - Enqiang Chen
- a Center of Infectious Diseases, West China Hospital, Sichuan University , Chengdu , PR China ;,b Division of Infectious Diseases, State Key Laboratory of Biotherapy , Sichuan University , Chengdu , PR China
| | - Lang Bai
- a Center of Infectious Diseases, West China Hospital, Sichuan University , Chengdu , PR China ;,b Division of Infectious Diseases, State Key Laboratory of Biotherapy , Sichuan University , Chengdu , PR China
| | - Cong Liu
- a Center of Infectious Diseases, West China Hospital, Sichuan University , Chengdu , PR China ;,b Division of Infectious Diseases, State Key Laboratory of Biotherapy , Sichuan University , Chengdu , PR China
| | - Juan Liao
- a Center of Infectious Diseases, West China Hospital, Sichuan University , Chengdu , PR China ;,b Division of Infectious Diseases, State Key Laboratory of Biotherapy , Sichuan University , Chengdu , PR China
| | - Hong Tang
- a Center of Infectious Diseases, West China Hospital, Sichuan University , Chengdu , PR China ;,b Division of Infectious Diseases, State Key Laboratory of Biotherapy , Sichuan University , Chengdu , PR China
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Smith CF, McManus B. The integrated anatomy practical paper: A robust assessment method for anatomy education today. Anat Sci Educ 2015; 8:63-73. [PMID: 24706567 DOI: 10.1002/ase.1454] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 01/31/2014] [Accepted: 03/20/2014] [Indexed: 06/03/2023]
Abstract
Assessing anatomy in a way that tests higher cognitive domains and clinical application is not always straightforward. The old "spotter" examination has been criticized for only testing low level "identify" knowledge, whereas other assessment modalities such as multiple choice questions do not reflect the three dimensional and application nature of clinical anatomy. Medical curricula are frequently integrated and subject specific examinations do not reflect the case based, spiral, integrative nature of the curricula. The integrated anatomy practical paper (IAPP) is a hybrid of the old "spotter" and an objective structured clinical examination but it demonstrates how higher levels of taxonomy can be assessed, together with clinical features and integrates well with other disciplines. Importantly, the IAPP has shown to be reliable and practical to administer. Data gathered from the Bachelor of Medicine five-year program over two academic years for four IAPP examinations, each being 40 minutes with (K = 60 items) based on 440 students revealed consistently strong reliability coefficients (Cronbach alpha) of up to 0.923. Applying Blooms taxonomy to questions has shown a marked shift resulting in an increase in the complexity level being tested; between 2009 and 2013 a reduction of 26% in the number of low level "remember knowledge" domain questions was noted with up to an increase of 15% in "understanding" domain and 12% increase in the "applying" knowledge domain. Our findings highlight that it is possible to test, based in a laboratory, anatomy knowledge and application that is integrated and fit for practice.
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Affiliation(s)
- Claire F Smith
- Department of Anatomy, Brighton and Sussex Medical School, University of Sussex, Brighton, East Sussex, United Kingdom; Academic Unit of Medical Education, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
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Haspel C, Motoike HK, Lenchner E. The implementation of clay modeling and rat dissection into the human anatomy and physiology curriculum of a large urban community college. Anat Sci Educ 2014; 7:38-46. [PMID: 23650279 DOI: 10.1002/ase.1369] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 01/03/2013] [Accepted: 04/18/2013] [Indexed: 06/02/2023]
Abstract
After a considerable amount of research and experimentation, cat dissection was replaced with rat dissection and clay modeling in the human anatomy and physiology laboratory curricula at La Guardia Community College (LAGCC), a large urban community college of the City University of New York (CUNY). This article describes the challenges faculty overcame and the techniques used to solve them. Methods involved were: developing a laboratory manual in conjunction with the publisher, holding training sessions for faculty and staff, the development of instructional outlines for students and lesson plans for faculty, the installation of storage facilities to hold mannequins instead of cat specimens, and designing mannequin clean-up techniques that could be used by more than one thousand students each semester. The effectiveness of these curricular changes was assessed by examining student muscle practical examination grades and the responses of faculty and students to questionnaires. The results demonstrated that the majority of faculty felt prepared to teach using clay modeling and believed the activity was effective in presenting lesson content. Students undertaking clay modeling had significantly higher muscle practical examination grades than students undertaking cat dissection, and the majority of students believed that clay modeling was an effective technique to learn human skeletal, respiratory, and cardiovascular anatomy, which included the names and locations of blood vessels. Furthermore, the majority of students felt that rat dissection helped them learn nervous, digestive, urinary, and reproductive system anatomy. Faculty experience at LAGCC may serve as a resource to other academic institutions developing new curricula for large, on-going courses.
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Affiliation(s)
- Carol Haspel
- Department of Natural Sciences, LaGuardia Community College, City University of New York, Long Island City, New York
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